Healthcare Provider Details

I. General information

NPI: 1225188253
Provider Name (Legal Business Name): LINDA BISNAUTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 CENTRAL FLORIDA PARKWAY CENTRAL FLORIDA BEHAVIORAL HOSPITAL
ORLANDO FL
32821
US

IV. Provider business mailing address

4601 CYPRESS LANDING LN
SAINT CLOUD FL
34772-7224
US

V. Phone/Fax

Practice location:
  • Phone: 407-264-7566
  • Fax:
Mailing address:
  • Phone: 813-300-3813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME110432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: